=====================================================
General NPI Number Information
=====================================================
NPI Number | 1962601823
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | CHRISTINE KAY MCBRIDE CNM
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/12/2007
-----------------------------------------------------
Last Update Date | 11/03/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2751 BAY PARK DR. SUITE #300
-----------------------------------------------------
City | OREGON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-691-7596
-----------------------------------------------------
Fax | 419-697-6707
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2751 BAY PARK DR. SUITE #300
-----------------------------------------------------
City | OREGON
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 43616
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 419-691-7596
-----------------------------------------------------
Fax | 419-697-6707
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 176B00000X
-----------------------------------------------------
Taxonomy Name | Midwife
-----------------------------------------------------
License Number | NM-09470
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 367A00000X
-----------------------------------------------------
Taxonomy Name | Advanced Practice Midwife
-----------------------------------------------------
License Number | COA09470NM
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------